Since low ER expressing breast carcinomas (1–10% ER positivity) are usually treated like triple negative breast carcinomas, we further investigated the concordance between pathologists’ reads and VIS reads using a 3-tiered system (ER <1%, ER 1–10%, ER >10%) and the results are shown in Table 3. The gene discussed is ESR1; the disease is triple-negative breast carcinoma.